Proton-pump inhibitors (PPI’s) are a group of drugs whose main action is a pronounced and long-lasting reduction of gastric acid production. They are the most potent inhibitors of acid secretion available today. They are employed by consumers and health care providers to treat the symptoms of heartburn (GERD- gastro esophageal reflux disease). Gastroenterologists, internists and most health care providers are concerned that constant irritation of the esophagus as a result of the reflux of stomach acid results in esophagitis (inflammation of the esophagus) and this may increase the risk of esophageal cancer and/or strictures of the esophagus.

Typically, physicians prescribe PPI’s for GERD- indefinitely. In general, proton pump inhibitors are well tolerated, and the incidence of short-term adverse effects is relatively uncommon. The range and occurrence of adverse effects are similar for all of the proton pump inhibitors, though they have been reported more frequently with omeprazole (Prilosec brand). This may be due to its longer availability and, hence, clinical experience.

You may have heard this week about a new study which found a higher risk of death among women who used certain supplements. It's a complicated study. Bear in mind that only white women ages 55 to 69 were enrolled in the study and they were followed for 22 years.Those taking calcium supplements had a 3.8% reduced risk of death. The calcium benefit ended, however, when taking more than 900 mg per day from supplements. It's worth noting that experts suggest many older women who take calcium supplements may not need to. I recommend NO MORE than 800 mg a day or the risk of cardiovascular disease is increased and so is mortality.The mineral most strongly associated with an increased risk of death was iron, which showed a risk increase of 3.9% -- and the risk increased as the dose increased, particularly over 50 mg per day. However, the study grouped dosages of under 50 mg together, making it hard to determine the risk of low dosages of iron, such as those in many multivitamins. However, there is very little reason why a postmenopausal woman should be taking iron. Although not as statistically meaningful, other supplements were associated with the following increases in the risk of death during the study: multivitamins (2.4%), vitamin B6 (4.1%), folic acid (5.9%), magnesium (3.6%), zinc (3.0%), and copper (18.0%).The bottom line: Don't take a supplement you don't need. Eat a BALANCED diet with 5 portions a day of fruits and vegetables and skip the Mickey D's!!!!

There is much that needs to be done with regard to Vitamin D. The Institute of Medicine has mistakenly taken a stance that minimizes the need for treatment and the transcendence of low vitamin D on our overall health. I say this because of the preponderance of literature showing the vital role that Vitamin D plays in prevention of disease (Diabetes, certain cancers, etc.) and in the treatment of others. My recommendations are MY interpretations but based on the present medical literature and guidelines such as the one recently unveiled from the Endocrine Society and others.

You should be maintaining your Vitamin D level at at least 60ng/ml . Although some experts suggest testing only those “at high risk” (obese, African Americans, pregnant and lactating women, patients with malabsorption syndromes and diabetics), everyone, I believe should be tested for Vitamin D levels (1,25 [OH] D) because the number of people walking around with what I believe are DANGEROUSLY low levels is staggering! The correct test is vital and must be administered by a professional.

As I mentioned on my radio show today, the issue of how much, if any, supplemental calcium you should take is unknown at this point in time. What is known is that there are many different uses, types, dosages, and risks of which the general public is shockingly unaware.

For instance, supplemental calcium may play a role in weight loss, possibly controlling lipids (fats in the blood like cholesterol and triglycerides), blood pressure and, of course, in maintaining healthy bones. However, in a number of studies taking more than approximately 800 mg of elemental calcium daily could increase the risk of a heart attack by 30%.